HomeMy WebLinkAbout06050127 Application
. City of Cannell Clay Township Permit #:CioD50 J.s.1...1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
STATE
N _
BEST METHOD OF CONTACT:
I ZIP
~le\ ~
NAME
PHONE
'b\'a'5t!,".j,~
cm
FAX
PROPERTY
OWNER:
PHONE
FAX
'1
CITY
STATE
I ZIP
4l.eO'1>3
\j..) .
LOCATION
& PROJECT
INFO:
LOT #
"';:,~3
SUBDIVISION NAME
~~
SECTION
ZONING:
";,-\
SQUARE ::i...LfOD
FOOTAGE: u...>5,6-.7
ADDRESS OF CONSTRUCTION
Sl'M.1<.-
SEWER UTILITY
PROVIDER: C).\L'MGI I.-
WATER UTILITY
PROVIDER: U&M..I..-
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) t crT. 000 _ "'..9
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITJON(S)
O/PORCH ADDITION(S)
~ REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
r~=:\'- ,_ n ~:,/? -r;;~l r;:~"\ l
l" ..'::.......", \i . ..-::;, I \'.
: i: I --~---~-:=-'1! 'j \i
PLUMBING CONtRACTOR: II!. J'JII
"->Tht", 'LA..>II' \11 MAY 1 7 2006
Plumber's India' ~e License #: I ~
k eaeOO b
NAME OF LfTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
Which plumbing code 'Will be cs......Ii-=d tv L1.eLDn
o J"temational Residential Code wI Indiana Amendments
~ Uniform Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release / Manufactured / FOUND~TION TYPE:
Permit: Y I N Trusses: Y / N constructIon area)
. - 7 ~ - 0 CRAWLSPACE
Lot Spht: _Y _N Sump Pump: ~ Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y ~N
(Check all that apply for the new
O..,....pOST & BEAM /:
elf BASEMENT
WALKOUT:_Y ~N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
Within 180 days Ml1!Adi~' ~I"I~ ~A~~fr~ug{l..rvust be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Cla:sUtjW, C\Ul.~' .. i!l'fm. ..t , .. s~~~~ flle1~hlUlNninistrative Rll~' fSSta te of Indiana (See 675 lAC 12) regarding expiration
Jac 10 OmPI!lnC8rlllillTrlijluEel!l~laIilMlI1gandcomple .' m~~e_
.I. the undersigned, agree tha,t cf~. ~~~~tt)rlnc:OO--"COO1991 enlargement, relocation,. ... . . i se of land or
structures requesrecIfDB~~a~iU\~Mt~e~I)~~ all applicable la\vs of the State 0 d , ' " 0 . ance of Carmel
In . . ana - 1993" (ZA~~~d~~iVjdbp~1-:f\\ddh ~th6'hY~ bfH936~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
,;t,he to. I further M\:!yTtl&Jbn~6:t1JMlSrV,,GlA1(r qr@WNSM-tpedtothesanitarysewer. I further certify that the construction will not be
'use r occupied until a C~';te o~I(J'\J'Aas been iSSU~ the Pepa"ment of Community Services. Ca,mel, Indiana. _
. ' .' ,....'hh? ~. -h~~\~ '":> -'1 - 0(.,.
'.\SignatureofOwne rA thori dent Print Date
OFFICE USE 0
***************************************~*~****~~*****************
Filing Fees: I) 7, , 'ill
INSPECTIONS REQUIRED: I /// () /i # Charged Re-
Base Inspections: _ _ (.L
Upper Footing Lower Footing Under Slab ' . ReViews
".. Cert. of Occupancy: S":'3 _ 50
~..!!i> Meter Base ~,... ~
c vx-.:~ Hl0-( ~-I?; '0{.,
ReviewedjApprov : Dept. of Community Services (Date)
S:PermitsjForms/ILP RESIDENTIAL
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